Background and Aim
Life expectancy is rising in Switzerland. As a result, the proportion of elderly people in need of assistance is also increasing. Support and care is offered by various providers. Older people often require a combination of services, but these are neither centralised nor coordinated, exposing older people to the risk of fragmented care.
Negative consequences of this fragmentation of care are the multiple use of services, gaps in the provision of information, inappropriate or contradictory recommendations and medication errors. This leads to insecurity, stress and strain for older people and their relatives. In addition, there are higher nursing costs due to unnecessary hospital admissions, emergency department visits and other unnecessary use of services generate unnecessary costs.
These adverse outcomes can be prevented by investing in integrated care models. INSPIRE investigates these urgent questions and shows how new care models can be implemented with high sustainability in real world care-settings.
The new care legislation “Altersbetreuungs- und Pflegegesetzt (APG)” in Canton Basel-Landschaft
In view of the demographic changes in the population in Canton Basel-Landschaft and the imminent lack of General Practitioner and health care personnel, the organisation of health care for older people in the canton has been reconsidered. On November 16th 2017, the District Administrator passed the new care legislation Altersbetreuungs- und Pflegegesetz (APG) (valid from 1. January 2018).
The new care law specifies a reorganization of Canton BL into larger care regions, which requires collaboration at the municipal level. Advisory Centres are to be established. These will provide information onageing, age-realted matters and support and care of older persons. A nurse will provide advice and assessment, especially for persons considering admission to a nursing home, to check the indication and possibly enable ageing in place with an adequate support system. A central objective of the care regions is to develop a care concept to ensure adequate outpatient, intermediate (e.g. day clinics) and inpatient care.
INSPIRE aims to develop and implement an effective and sustainable community-based care program for senior citizens in Canton Basel-Landschaft using new methods of public health and implementation research
The project is divided into two consecutive project phases: Phase A encompasses all preparatory work and work in progress. This includes the organisation of a cantonal and local stakeholder group actively engaged in the development and implementation of the integrated care model, the identification of international evidence-based literature on evaluated integrated care models, a context analysis with which the current community-based health care in Canton BL will be determined, and the development of a training course for the nursing staff of the advice centres.
Phase B comprises the implementation and evaluation of the INSPIRE programme, which is based on the integrated care model developed in Phase A. While the INSPIRE programme is implemented in two care regions, repeated population surveys of the older population throughout the canton will be conducted. At the same time the feasibility and effectiveness of the INSPIRE programme in the two care regions will be evaluated. Furthermore, a geospatial analysis will be undertaken in Canton BL to determine the future needs of the older population.